Kido Hidenori, Kato Shunsuke, Funahashi Kimihiko, Shibuya Kazutoshi, Sasaki Yousuke, Urita Yoshihisa, Hori Masaaki, Mizumura Sunao
Department of Radiology, School of Medicine, Faculty of Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, Tokyo, 143-8540, Japan.
Department of Oncology, School of Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
EJNMMI Res. 2021 Sep 6;11(1):87. doi: 10.1186/s13550-021-00831-5.
A combination of positron emission tomography and computed tomography (PET/CT) is an important modality for the diagnosis of carcinoma. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have been reported as metabolic parameters in PET/CT since the late 1990s, and they are expected to be useful in diagnosing diverse cancers and as prognostic biomarkers. We evaluated the potential of these parameters in the prognosis of colorectal cancer (CRC) by comparing them with conventional parameters, including the maximum standardized uptake value (SUVmax). We enrolled 84 patients who underwent surgery for CRC without distal metastasis between April 2015 and April 2019. SUVmax, MTV, and TLG were measured by F-fluorodeoxyglucose (FDG)-PET/CT. To find an optimal threshold value related to prognosis, the volume of interest in the primary carcinoma was measured at fixed relative and absolute thresholds based on SUVmax (30%, 40%, and 50%; 2.5, 3.0, and 3.5, respectively), tumor-to-liver standardized uptake ratios, TLR (1.0, 1.5, and 2.0), and SUV normalized to lean body mass, SUL (2.0, 2.5, and 3.0). After classifying the patients into two groups according to pathological N stage, the optimal threshold values of all metabolic parameters were compared between groups using a non-parametric comparison test.
The most suitable thresholds for MTV were a SUVmax of 3.5 and a TLR 2.0. TLG with a SUVmax value of 40% showed the most significant difference. The MTV standard uptake ratio of 2.0 was significantly associated with pathological N stage.
Our results suggest that an MTV TLR 2.0 on PET/CT reflects pathological N stage in local patients with CRC.
正电子发射断层扫描与计算机断层扫描相结合（PET/CT）是诊断癌症的重要手段。自20世纪90年代末以来，代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）已被报道为PET/CT中的代谢参数，预计它们在诊断多种癌症及作为预后生物标志物方面将发挥作用。我们通过将这些参数与包括最大标准化摄取值（SUVmax）在内的传统参数进行比较，评估了它们在结直肠癌（CRC）预后中的潜力。我们纳入了2015年4月至2019年4月期间接受无远处转移的CRC手术的84例患者。通过F-氟脱氧葡萄糖（FDG）-PET/CT测量SUVmax、MTV和TLG。为了找到与预后相关的最佳阈值，基于SUVmax（分别为30%、40%和50%；2.5、3.0和3.5）、肿瘤与肝脏标准化摄取值、TLR（1.0、1.5和2.0）以及归一化去脂体重的SUV、SUL（2.0、2.5和3.0），在固定的相对和绝对阈值下测量原发性癌的感兴趣体积。根据病理N分期将患者分为两组后，使用非参数比较检验比较两组间所有代谢参数的最佳阈值。
MTV的最合适阈值为SUVmax 为3.5和TLR为2.0。SUVmax值为40%的TLG显示出最显著差异。MTV标准化摄取值为2.0与病理N分期显著相关。
我们的结果表明，PET/CT上的MTV TLR 2.0反映了局部CRC患者的病理N分期。
